About This Site

My name is Graham and I'm from Canada. In 2010, I had double jaw surgery to correct my class-3 malocclusion (also know as a "severe underbite").

You can follow my day-by-day road to recovery on this blog. It took just over 90 days for my life to return to normal and the changes were well worth the trouble. If your bite has been bothering you for a while, I highly recommend this operation to correct it.

Despite trying to walk away from this blog twice (here and here), I’ve been drawn back yet again. It seems helping people through the experience of having jaw surgery is something of an addiction.

Perhaps most importantly, I should let you know that I am back to help answer your questions (and have been doing so for nearly 2 months already). It’s been encouraging to see people helping each other out in the comments as well, so thanks to all of you who are sharing your own wisdom with people new to this surgery.

In case you’re wondering what happened during my 5-year hiatus, I’d like to share a few brief updates on my life since my previous “final” post.

After 6 years in university, I finally graduated with a degree in Computer Engineering. I’m not sure what that means, exactly, but many adults seemed to think it was a good thing to collect.

I let all of my professors down by opting to become a traveling bum instead of getting a desk job. In 2012, I traveled around this blue and green orb God gave us (also known as Earth) and discovered friendly, hopeful people all over the place. The year-long experience involved many long bus rides, sleeping on park benches, eating frogs, walking cheetahs, and seeing the number $0 on my bank statements. (I was also lucky enough to spend Christmas in Malaysia with a fellow jaw hero!)

We moved to Thailand because we’re wimps when it comes to winter in Canada. We have not stopped sweating since that day. 😅

My commitment to being a computer geek finally paid off and spurred a career in programming. I now work as a remote software engineer from all corners of the world. (Today, I’m writing this blog post from the town of Siem Reap in Cambodia.)

I learned that I like cats.

This is the girl I met. (Also, my wife.)

Since this is a blog about jaw surgery, I suppose an update on the current state of my jaw would prove useful as well. 😁

I still wear my retainer 2 nights per week, a habit lovingly enforced by my wife.

I now floss every single night, another habit forced encouraged by Roma.

I still have permanent numb patches in my lower lip and chin, but they do not negatively impact my life in any way (except maybe for those awkward moments when I have water running down my chin and nobody has the courage to tell me about it).

I can eat and drink anything and my open bite no longer affects my chewing.

Finally, even 5 full years after my recovery, I still highly recommend this surgery for anyone who has difficulty chewing or feels an extreme lack of confidence due to their smile.

If you have any questions, or perhaps just want to say hello, feel free to leave a comment below and I will happily respond.

I wish you all a very happy new year and hope to meet even more of you in 2016!

Want to chat live with other patients?

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96 Comments

I just wanted to say thanks for keeping this site up. I read it months ago when I was preparing for my own double jaw surgery, but then I read it again this last week (first week after having my procedure) and found it to be much more pertinent! I also thought some of your posts were funnier after having my own surgery (I had to work hard not to hurt myself smiling or laughing).

AJ, glad you found the blog useful! I imagine these posts make very little sense to anyone who hasn’t been through the surgery, but there’s a whole new world of understanding waiting on the other side, hehe. Best of luck as you survive the first few weeks of recovery! 😊

I’ve been following your blogs for couple of years now, I had my surgery in August 2014 so it’s bee two years now. You’re blog really helped me get through a major chunk of the recovery process . I have a question , what do you know about the bone settling after surgery, meaning – does all the bone become stronger be more difficult to break if there is impact to the face ? (After two years)?
Reason I ask is that a mirror with a wooden frame hit my face , I seem to be ok and no pain but I’m wondering if I should do get an X-ray ,
I’m not sure about you but the post survey trauma , anxiety hasn’t really gone away and something like this has really shaken be up. I see No signs of bleeding, (at least externally) so something like this has my thought racing a million miles an hour wondeing if there was any damage done .

Will, I asked my surgeon this same question a few years ago and he told me that the bone will be as strong as it was prior to surgery. Since we’re talking about surgical cuts here, the bone is able to heal very cleanly and should result in any areas of weakness. If you are not experiencing any pain or clicking sounds as a result of the incident with the wooden frame, I wouldn’t worry about it. However, if pain or abnormal swelling does arrive, I would recommend going for an x-ray at that point. I think you should be perfectly okay, though! 😊

Hi Graham!
Thank you so much for the prompt reply,
It literally happened last night , and I immediately googled “double jaw surgery and bone strength after recovery” and your blog popped up I was so surprised to see you continued helping guide others through their journeys post-op. I’m feeling fine this morning just kinda like I got got socked in the face , ha!
The information you provide really helps a lot of people!!! Thank you again !
Will

Is it very difficult to fall asleep after jaw surgery? I have a history of insomnia (I once stayed up for 9 days straight, but that was because I needed to have a major operation ). I’m a side sleeper, I usually don’t have trouble sleeping unless I’m uncomfortable. I’m worried I won’t be able to sleep for another week straight due to pain, not breathing, or having to sleep on my back .

Andrea, sleeping during the first month of recovery is certainly difficult for a variety of reasons. You’re encouraged to sleep on your back to avoid putting undue pressure on any part of your face and the swelling and discomfort prevent you from getting a full night’s rest.

I found that during my first month after surgery, my sleep cycle was similar to that of a cat (as odd as that sounds). I would nap for a few hours, then get up and watch TV or read, then nap again, then go for a walk, etc. That being said, remember that this part of the recovery is temporary and you’ll be able to sleep the same the same as before by the end of the first month. My only tip is to get a hot pack to sleep with as the heat can sometimes soothe you into better rest. 😊

I had upper jaw surgery five weeks ago today. I was wondering if you experienced a “stiff” lip to any extent. I’ve noticed that my upper lip feels stiff and awkward when I talk, and I wondered if you had that experience and if so, how long it lasted. I also have looked at all your photos and I didn’t see many at a partial profile angle. I feel like that’s the angle that makes my swelling most noticeable. Did you notice that too? I feel like the lingering swelling is on the portion of my cheeks closest to my nose, and it seems very stubborn! I was wondering if you had swelling in that area and if it seemed to be the last to go.
I have really enjoyed your blog! It’s been a great source of comfort in this nerve-wracking process!

Lucy, I do recall having a stiff upper lip throughout my recovery and I believe this is due to a combination of swelling and scar tissue. The swelling will simply go away in due time, so patience is your strongest game in that regard, but the scar tissue requires a bit of work to get rid of. I was told to whistle several times each day as this makes your upper lip move and twist, which helps break up that scar tissue. Keep in mind that if your lip cracks when trying to whistle, you should hold off for another week and then try again. On an encouraging note, at 5 weeks into your recovery, the chances of swelling being a major contributor are still high, so most of this will go away on its own.

As for swelling in other areas of your face, try to remember that it will take a full 4–5 months for all of your swelling to go away, so it’s very common to still appear quite swollen at this point. I know it’s frustrating, but hang in there and try not to pass any judgement on your appearance for at least another month. Stay strong! 😊

I also am 5-1/2 weeks post op and my upper lip is the same. It’s sooooooooo frustrating. My Dr told me to pucker like a kiss and then smile wide. Do this often. It really does help. I also find tjat sleeping with wax on my upper braces helps as well. If I’m not going anywhere I leave it on all day. Hope this helps

I remember the stiff upper lip too, it does go away with time. It was really frustrating with talking and smiling. I found forums like this and youtube to be a great way to feel less isolated in my recovery.

My nose stayed swollen for the longest and was the last to go down only after 6 months, there were times when I worried if my swelling would never go down and if my smile would ever look normal but all was well in the end.

Hi Nicole , that is great to hear about your nose, I’m nearly 6 months post op and I hate my nose. It is much wider than before snd worse when I smile. It is good to hear that maybe even after 6 months it might go down more. I’m praying it will and this is not the final result but I don’t know.

Hey everyone!-It is encouraging to hear all of your stories and how recovery has gone for each of you! I am 30 years old, and set to have jaw surgery at the end of September 2016. My surgeon had planned to just do the upper jaw (move it forward, and also widen it-so 2 breaks there). However, when they called to check in to see how everything was going, I told them I was a little nervous they may need to do something with the lower jaw. I went in for more xrays and they decided now I will be having surgery on both jaws! (Due to removing my widsom teeth and braces, lots of movement has occured!)-as you all are aware of, surely! Anyway-my surgeon says that I will NOT have to be wired shut. I will only have a splint on the upper and then rubber bands that connect to the surgical hooks. What a relief to not have the wires. Wondering if any of you did not have to be wired shut?

-They also say I can go back to work after 10 days…I am a little nervous for this, because I am a nurse and want to be able to communicate with my patients, and tolerate being up and about on my feet for the 12 hour shifts. Most of the blogs I have followed talk about some weakness and lower energy levels. For this reason I am planning on taking about a month off. Any advice/tips would be helpful, I have read up on everything but I think my nerves are starting to take over…It seems like I have been waiting my whole life for this process!!

Hi Gina, welcome to the family! As far as I understand, wiring people’s jaws shut is a relic of the past and most people’s jaws are held together with tight elastic bands around their brackets nowadays. I also had a splint in the roof of my mouth and elastic bands holding my jaw together after surgery. During the middle and later stages of recovery, you can remove the bands for eating, so it’s only the first month or so that you’re really restricted.

As for returning to work, I highly recommend taking one month off if you’re required to communicate with people at your job. As you’ve read, you’ll likely be lacking in energy and you may find it difficult to speak clearly for the first month. Your surgeon’s recommendation of returning to work as a nurse just 10 days after double jaw surgery is setting unrealistic expectations, in my opinion, so props to you for doing your own research and knowing what to expect.

Sorry to hijack your post, I’m a midwife and day 10 after double jaw surgery. There’s no way I could return to work today and communicate effectively with my patients. Also my energy levels wouldn’t allow it, I’m constantly tired and hungry and irritable. I’m due to go back the 19th September, exactly a month after surgery.

Hello Graham! 😀
I don’t know if you will remember me but anyways, I had my surgery done a month ago! I am so glad that it is over. The first three days were the worst days of my life literally. I underestimated the pain… I could not sleep for 72 hours. The surgery went perfectly well without any nerve damage but I had to pay so much in return. I can open around 35mm of my mouth now. Although I still look like a chipmunk, I am hoping I can tone down in the next month.
Thank you again for letting me prepare for this surgery through your experiences.
God bless.

Irene, welcome to recovery! I am very happy to hear the awful first few weeks are in your past already, but sorry to hear that you experienced a lot of pain. Perhaps I should update some of my posts saying that my relatively painless experience is not the rule, but is rather just how my body personally responded.

Hang in there for now and remember that each week will be easier and more rewarding than the last at the point. The worst part of the storm is behind you. 😊

Thanks Graham! You are so kind 🙂
Yes, I did experience a lot of pain because my nurses did not know how to take care of double jaw surgery patients. They took forever to give me pain killers as they did not reach my doctor quickly. Therefore, I transferred to a different floor that had nurses that specialised in double jaw surgery. They were angels… After three days in the hospital, my pain was mostly all gone.

Thanks Graham again. I am just waiting for the time to pass while watching Netflix 🙂

I’m 66 years old and had bilateral TMJ replacement, Lefort I osteotomy, and genioplasty done during a 13-hour surgery 18 months ago. While the primary reasons for doing the surgery have been corrected, the unexpected issues that now remain – numbness in lower left lip and chin, decreased sensation in the upper palate – in addition to the bite issue which makes chewing effectively very difficult, make it seem like this will never end. I am in Invisaline for the bite and hope that at some point eating will get easier. Meanwhile I have lost 125 pounds (needed to lose about 60) and the doctor wants me to gain weight. That is hard when you can’t eat! Etc.,etc.

My main reason for posting is to say that I appreciate reading about each of your experiences here while I try to deal with and accept what appears to be my new normal.

Karen, sorry this is such a frustrating experience for you. Know that you’re not alone and I’ve met dozens of others who also had to go through multiple surgeries to correct their bite. Thankfully, it sounds like you are nearing the end of the process, so I hope the Invisalign approach works and the strength in your bite returns soon. Take care for now! 😊

Hi Karen what is wrong with your bite now and what was wrong with it previously that caused the TMJ issues? I am 41 so I too am one of the “older” people looking into jaw surgery. Mine is for sleep apnea but I dont think my bite is all that good either. Numbness, even permanent numbness, is something to be expected, especially for people who have the surgery later in life.

I just sent this via an email reply, so apologies if it actually shows up here twice.

Hi TallKnowItAll-
Prior to my surgery, I had extreme ankylolsis (bone growth most likely resulting from scar tissue from procedures done over 30 year ago) that made me have a very limited opening. Then while determining how to attack that we discovered sleep apnea. Since surgery, my teeth do not meet on the sides enough to allow me to chew effectively, with very limited contact in the front as well, which is why I am in Invisaline. This was not an expected outcome! I had no trouble chewing previously, once I was able to get the food in my mouth. As for the numbness – I knew it was a possibility, but not to this extent! Add that to the longer amount of time that it takes us “older” folks to heal/recover (and some other complications) and it makes for quite an experience. While I know it was my choice to have the surgery and prognosis for the future was bleak, I really wish I could find some good research on length and degree of recovery based on age, and also at what point no more improvement should be expected. How far are you in determining whether/when you will proceed with your surgery?

Omg- you lost 125 lbs! Thats allot of weight .. i am 52 and having double jaw surgery on December 7th.. would not mind losing 30 lbs but am very nervous about the permanent effects and the recovery process…this blog has certainly helped prepare..

Hi Stacy –
I understand why you nervous about recovery and long term effects of your surgery! The best advice that I can give you is to try to remain patient. I could not notice improvement on a daily or even weekly basis so I just had to keep trying to do what I was supposed to do and eventually I was able to see some change. I am not a patient person, so that was, and still is, very difficult for me. I wish I could say I was at the end if this journey, but I’m not. My weight loss continues and is causing great concern for my PCP! I keep giving myself the positive pep talk multiple times a day…. I’m glad you found this blog because I do think it is informative to see what others have experienced as you prepare for your surgery. I wish you the best and hope you will check back in and let us know how you are doing.

Sorry, duplicate comment of my last one cause wasnt sure if anyone would see it on an old post. Had double jaw surgery three years ago and im still getting pain during winter. Using a heat pack helps a bit and its usually only during the two coldest months so its not completely unbearable. But still keen to know if this is normal as i dont know anyone else in real life whos had this operation.

is it only during the winter? Why did you originally get the surgery? TMJ pain…? Overbite?
I had my surgery almost 2 years ago and I am still in almost constant pain. I think it’s risidual from the pain I felt before the surgery. My bite has also shifted since. I am back in splint therapy 🙁

Oh my gosh, I’m so sorry to hear that, how terrible to go through all fo that and have it shift back. Was yours for TMJ?

Yes, it’s only during winter, I got the surgery for an overbite. And now I get a stiff kind of pain in winter, and I was just wondering if it was to do with the metal getting cold as there is very little flesh around the jaw area. Since I posted here I spoke to my surgeon and he said it’s normal to have stiffness in winter.

Thanks! Yeah, it’s pretty frustrating as the science is now over my head…
My sinus area gets stuff in the winter too, definitely the titanium in me getting cold (which is crazy)!!
I have not been able to find anyone going through T what I went through. I did get the survey for TMJD .. My doctors say I may have to get a joint implant in a year which would blow. My jaw surgery was intense- took about 8 months to recover

I’m on day 12 and I’m having a really hard time. The last day and a half my face has been in so much pain. I can’t even smile. All I’ve been doing is sleeping since the surgery. If I take pain killers I sleep. If I don’t take pain killers the only release is sleep. I’m starving all the time. Is it normal to be in this much pain still and this miserable. It feels like I’ll never be better.

You will!!!!! I’m on day 16 and I’m finally finding my groove. I look crazy when I smile and laughing… Forget about it. But it’s starting to come back slowly. In terms of pain and pain killers… I would ask your doctor about what might be normal in terms of your personal surgery. But I am missing smiling too!!! I feel your pain! Keep on trucking!!!!

Hang in there. I had lower jaw surgery in 2014 and in my experience the pain got worse days after the surgery . All the nerves and muscles are slowly getting back to normal. This I think causes all the pain. Remember this is a pretty intrusive surgery. Hopefully the pain has gone away by now. For me the pain spasm were the awful at night while sleeping. Like the worst pain I’ve felt in my life I think. Hope your getting back to normal.

Today is 6 weeks since my surgery. I posted a couple of pics of the evolution of my face (swelling) on my Facebook. In case anyone is interested (probably not, but it did help me quite a bit to see other people’s faces and what they had gone through, so just in case) I am embedding the post here (I hope):

Thank you so much for your posts! My surgery was two weeks ago and nearly the same as yours but included the splitting of the upper jaw for an open bite. I’m on the beginning of week three and having ups and downs. My swelling is very similar to yours and it was nice to see the transformation and lessening of it. Did you have any pain in your molars as your feeling returned? And when did you start exercising again? I’m an avid runner/yogi. Thank you so much for your blog!!!

Megan, I don’t recall feeling any pain in my molars during recovery, but I don’t think that’s anything to worry about. If it lasts more than a day, you may want to ask your surgeon about it just to ensure it is not an infection.

As for exercising, I returned to the gym after 6 weeks but was slow and careful not to exert myself too much. There’s no hard timeline on when you can begin exercising again, so as soon as you have the energy, feel free to give it a go. Just be careful not to bump your face or put any excessive stress on it. Good luck! 😊

I talked with my surgeon today and apparently it’s super normal pain! 👊🏼 I had my upper jaw cut in half down the middle and in three other places and lower cut in 5 and sinus reconstruction so I think I’m just impatient with the healing process. Thank you again for your thoughtful insights on the patience part!

Megan, I started lifting weights on day 12, which probably was pushing it. Running for me was too hard because it makes your face feel weird. If you want to workout I would keep it very easy and slow.

And remember, YOU NEED TO UP YOUR CALORIES. I learned that when your body is healing your metabolism sky rockets. If you workout and burn 500 calories, you have to eat those back and then some. I lost 25lbs in a little over 2 weeks. And when I leveled my weight off, I still am Ewing ice cream and drinking chocolate whole milk and not gaining fat. The more calories you consume the faster you will
Heal.

That’s good to know! I’m a pretty small person and already down 12 pounds. I’ve got a 3 year old so although I haven’t been “exercising” I’ve been getting an average of 10k steps since day 9. I hit a wall in the afternoon though. May be the calories! It’s been hard to get in enough. Thanks for the tips!

Thank you!! Just talked with my surgeon and they are going to take the splint off two weeks early which will help. This recipe is perfect- thank you!!! It’s encouraging to hear others who were anxiously waiting to get back to the grind. 👏🏽

I’m about 4 weeks post-op and just wanted to say thanks for your great blog posts. I’m quite lucky with my surgery actually, it took less time than the surgeon planned and I didn’t have to wear the splint at all. So I feel quite lucky compared to many of you.

I’d say right now, the biggest complaint would be the fact that my jaw jerks around involuntarily (I think these may be the spasms you mentioned?) At this point I’m trying to tolerate it, but I’ll probably mention it to my surgeon at the next post-op.

Luckily, I’m off the liquid diet but I’m on the no chewing restriction. So my favorites are egg drop soup, lo mein and chocolate frosting (as a young college student, chocolate is a requirement). I’ve also taken the cheese and sauce off the top of pizza and I’ve been able to eat it. I also cut up peanut butter cups (another favorite) into really small pieces and have those as a treat. On the topic of food, I never realized how many food commercials are always played on television and how much people talk about it… we sure take our health for granted xD

Trying to keep a positive attitude for the future. I’m looking forward to being able to bite into things normally (I was told by my orthodontist, that my front teeth never worked properly). So, that’ll be great.

Finally, I love the little community we have built around this experience. It surely is a unique one ^^

So I am in week 6. I had an appointment with my surgeon a few days ago and I was supposed to get my splint out. Upon reviewing my x-rays he said he would leave it in and wait to take it out in two weeks. He seemed kind of rushed, and said that even after he took it out I needed to be on a “mush or liquid” diet for 12 total weeks.

This was kind of a let down. I had upper jaw surgery, Lower jaw advancement, and they slid my chin forward as well. They also used bone grafts. Now, as I told you before, the first week was bad and then everything started getting better. I am a firefighter and was eager to get back to working out, so I could transition back to work easily. (surgeon says 8-10 weeks post op before I can work again). I admittedly pushed it a little too much early. Day 12, I was back in the gym lifting light weights. I was careful not to over exert myself or clench my jaw. I had no issues and continued to stay active. I was cruising along, eating the mush food diet and I thought everything was going great. 21 days after I took a rope rescue class that involved 2 evolutions of me rappelling off of a building. Again, no issues. I dont have pain, my feeling is coming back although my entire lower lip and chin are still completly numb. The swelling has come down to the point where most people dont notice, and I honestly don’t see any issues.

That all being said, after looking at the X-ray and still seeing gaps where they placed the bone grafts, I for some reason am concerned that I am pushing my luck way too much.

I had my splint removed on the 49th day of recovery, so I suppose your surgeon wanting to leave your splint in for a couple more weeks is not unheard of. I will say that I have not met a single person who wore a splint as long as I did, though.

I think your training should be fine as long as you never felt any pain during the process.

As for the x-rays, remember that it does take a full 12 weeks for your bone to fill in, so seeing light gaps after 6 weeks is to be expected.

The only suggestion from your surgeon that I’m confused about is staying on a liquid diet for the full recovery. I wouldn’t fret about it right now, but I certainly recommend asking them for an explanation of why they think a liquid diet is necessary for such a long time. Most people graduate from liquid to soft food when their splint is removed.

If you remember, please let me know the outcome of your appointment in 2 weeks. Best of luck! 😊

That’s good to know! I’m a pretty small person and already down 12 pounds. I’ve got a 3 year old so although I haven’t been “exercising” I’ve been getting an average of 10k steps since day 9. I hit a wall in the afternoon though. May be the calories! It’s been hard to get in enough. Thanks for the tips!

Had my appointment today, Surgeon removed the split, is very pleased with the results. I can return back to work on 7/8, which is exciting. The feeling is weird, only about 3 or 4 of my teeth touch. Orthodontist also put me in the normal wires instead of the hooked mess I was in, and let me brush all the gunk off.

I also got the go ahead to eat, but softer foods first. So i immediately crushed a plate of tacos.

The surgeon did find a sore in the back of my mouth that was open, he drained it and gave me a rinse. I also got a script for antibiotics, He didn’t seem too worried about it, and to be honest I had no idea it was even there. Hopefully the Braces move fast!

Hello everyone!!! I would like to ask anyone that is 6 months post op or more on what is expected to feel at this point! So as for me this is how I feel…
I’m still numb on my lower lip, chin and gums 😓
My gums hurt when I brush or floss.
I still can’t open no wider than 2 1/2 fingers
I bite my lower lip constantly
My lip area feels very tight and it makes it hard for me to speak well 😏
I still can’t taste certain foods, which sucks big time 😭
So if anyone could please tell me if this is normal and when will I start feeling like my self… I just want to feel normal again pre-op… I was told by my surgeon you start feeling normal at 6 months but I’m not 😢

Hi Rachel,
I feel your pain, I am about 9 months out. I assume its a little different for everyone, but I had & still have a lot of the same issues as you. I know what you mean about the numbness on your gums & inside as well, I lose food sometimes because its hard to feel it. My lower lip & part of my chin is still numb (although I think it may have improved a bit) the tingling that is almost painful is normal too, my guess is its nerves trying to regenerate. I have the tight lip problem too, I have to concentrate at times to open my mouth when I speak, & opening is difficult, my surgeon told me to practice stretching every day & to even insert your fingers in your mouth to apply pressure for opening further. I was also told it could take up to 2 years for my healing to be exactly what it will be. I imagine though within a year it would be pretty much it. In any case don’t give up hope yet. I was like you hoping in 6 mo. I would be so much better, but I think I make slight improvements still as time goes on. Good luck to you!
Emily

Hi guys, and hi Graham, thanks for this website! Have been lurking for a few weeks and thought I’d finally leave a comment, since my surgery seems to be a bit different. I had it in Barcelona, Spain, so maybe they are just trying to be original there :o)

I had my double jaw surgery 4 weeks ago. Had an overbite/open bite plus TMJ/TMD so had to correct it with TM joint surgery first (did it 2 years ago, and may I say it was a piece of cake compared to this), then braces, and now double jaw surgery.

Speaking of cake, I wish I could have a nice piece right now, but unfortunately I’m still in the soup phase, lol.

Anyway, so they cut my upper bone in a piece along the 4 front teeth and pushed the whole thing forward to close the open gap (teeth were now perfectly aligned thanks to braces). I am wearing those fun little rubber bands to keep my mouth shut — everyone in my family is sooo happy about this :o) — but the first couple of weeks, if I pushed my tongue up, I could actually feel that portion of the bone swivel forward, and my 4 front upper teeth move down by themselves. Not painful but kinda creepy. I didn’t do that frequently so as not to mess with the bones sealing again. I don’t feel it moving as much anymore, which I take it as a good sign that the bone is fusing as it should.

They also cut my lower mandible and opened a gap on both sides, of about 1 cm each, which is where the lower bone needs to regenerate and fuse again. This extended my lower jaw 1cm forward to correct my overbite.

So, four weeks now, been taking lots of long walks and eating lots of home made veggie and protein soups, and it looks like I am healing properly, despite my 46 years of age (gasp!). But have a few questions that I haven’t seen answered so here they go:

During my procedure, almost all my lower teeth brackets were removed or broke down or something (I prefer not to think of what they might have been doing for this to happen), but anyway, they still wanted to keep my mouth shut at the end of the surgery. But with no lower brackets, there was no place to attach the rubber bands to, so the doctor actually screwed in an actual screw straight to my gums under my lower front teeth so he could attach the rubber bands there until I got my brackets fixed, which happened about 10 days after surgery in a pretty tortuous event which I shall not describe for your own good :o)

Did this happen to any of you? I guess the guy had to improvise with no brackets. It didn’t hurt the first few days as I was under medication, but eventually it did bother me, not horribly, but I unscrewed it from my gums with the nurse’s permission. Probably one of the most surreal things I have ever had to do :o) Didn’t hurt, for those wondering. Was just weird.

Also, one of my teeth seems to be changing color. It’s the one right next to the cut on my upper jaw, so I wonder if this also happened to any of you? I am hoping it is not dying (RIP). Could still be fixed with a crown, but still.

Other side effects that are still clinging on are: My face is still a bit swollen. Is this normal? Plus I am also still feeling quite fatigued. I can do stuff, but I do get tired quite easily. Did this happen to you guys as well?

And another weird side effect: I am not taking any medication anymore, but it still feels like my brain is not totally there, as you have probably guessed by my writing :o) It’s like I’m a bit tipsy or something. Did this, again, happen to any of you? Maybe this surgery just triggered early senility? that’s probably it lol.

How long do you think it takes for you to recover ALL your strength and for ALL the swelling to go away? and for ALL systems to go back to normal?

So, anyway, that was that. Sorry if it was too long, but since this is THE website to go for those of us who have had to endure the joys of jaw surgery, I figured I’d contribute my two (hundred) cents.

Thanks for all your super helpful posts, thanks Graham specifically, and for those still recovering: keep strong!! :o)

Hi Susana, thanks for sharing your story! Each time I hear this surgery described, I realize just how ridiculous it must sound to people who have never been through it. Welcome to the other side. 😊

To answer your questions:

1) Removal of lower brackets: I haven’t heard of anyone who experienced this and I can’t think of a reason these brackets would be removed during the operation. I wonder if your surgeon accidentally bent a few of your lower brackets during the operation and then decided to remove them because they would need replaced anyway. In any case, a weird situation, but I’m glad it’s all resolved for you now. Removing that screw must have felt bizarre.

2) Teeth changing color: If your tooth is turning yellow, this could indicate a breakdown of the enamel, which allows the dentin to show through. If it’s turning a dark color, it may indicate a broken blood vessel inside the tooth. In either case, I think your only course of action is to ask your orthodontist. It’s probably nothing serious, but definitely worth checking out.

3) Swelling: Being really swollen at the 4-week mark is very normal. Most of your swelling should be gone after 2 months, but residual swelling may take up to 4 months to go away.

4) Fatigue: Feeling fatigued and and feeling like you are lacking a bit of brain power are likely both related to the fact that your body is spending a lot of energy healing the cuts in your jaw bone during a time when your body is receiving less energy due to reduced food intake. Again, it’s normal to feel this way until around the 6-week mark, so nothing to worry about.

I hope this helps and I also hope you can have a piece of cake soon, hehe. Take care for now!

Graham, if you don’t want to be an oral surgeon, maybe you can just be a post-surgical consultant 🙂 You’ve got a lot of good info.
My 3 hour operation ended up taking 6. Only thing doc said on my 1 week follow up was that he had a difficult time finding a good amount of bone for the repositioning of my lower jaw. I know one of the reasons for this surgery was I had some bone loss from my malocclusion. I don’t necessarily think this was related, but I’m pretty sure he made small incisions through each cheek to gain access to that back area.
All that to say, I think stuff happens during surgery they’d rather not tell you. I woke up with a couple small scabs on my forehead near my hairline (weird). 25% of my right eyebrow was removed (weird). And my upper right canine tooth seems to be chipped on the back side. I may end up asking him about that one. Just don’t want to say, “Hey, did you mess up?” when I’ve got a few more follow-ups with him.

Joey, those are weird things to wake up to (especially your eyebrow being shaved). I also agree that managing these relationships while demanding answers can be tricky. I would guess that surgeons don’t want to stress people out by mentioning every little detail when the purpose of the operation is to solve “the big problem,” but since it’s generally something you only do once in your lifetime, it can be nice to know those little details.

As for having lots of info about the operation, to be honest, I search most of it and then pass my findings along here. That’s what my support role has become… “Let me Google that for you.” 😂

Thanks Graham for all your comments. I am not sure you expected your blog (and yourself) to turn into this jaw surgery knowledge database when you started it, but I personally I’m glad it happened :o) Cheers!

Did you have surgery with Dr. Federico Hernández Alfaro? He’s supposed to be really good and a few of his patients that I have spoken to say his faster surgery times and less invasive cuts he makes really shortens the recovery process.

Hi, yes, I did it with Dr Federico Hernandez Alfaro, and yes, he (and his team, especially the nurse, Nieves) is really good and I am very happy to have done it with them.

I saw him yesterday for my 5 week checkup and he says everything looks perfect. And, except for some small-ish lingering swelling, which I read is still normal at 5 weeks, I do feel pretty good and am now resuming orthodontics for I hope not too much longer, but also, most importantly, can go back to sports and having a normal life. Even my brain seems to be back to normal, which is quite a challenge in my case :o)

I don’t think he used his technique of performing numerous smaller cuts as opposed to just one big one in my case, but in any event, it looks like it all went well. The only thing I wish would have been a bit different is that one of my teeth is changing color, probably bc of not enough blood supply. He says it may still recover, otherwise can be whitened from the inside (?) I’ll have to research that, but have to wait for a month and see what happens first.

He also did my TM joint surgery a couple of years ago. This whole thing was to correct my TM Disorder, and since then I really have not had any issues with my jaw getting locked anymore (used to get off its hinge ever.single.day for years ugh!), and also corrected my Eustachian Tube Dysfunction (my ears used to get blocked as well, probably from jaw pressure), which was not the goal of the surgery, but was a super amazingly nice bonus.

So, yeah, I would definitely recommend him if anyone is in Barcelona for this surgery and if you have any questions about him feel free to ask :o)

Hi Graham! I’m going through a double jaw surgery in 3 weeks from now and I’m mentalised recovery will require A LOT of pacience but I’m sure the results will be worth it. I’m enjoying your blog and HUMOR very much 😁. I’m glad you were able to avoid a desk job hahahaha. Hugs from Bolivia

Hey Graham (and anyone else who may have had the issue I have):
My wife found your blog, and I just finished (at least I think) reading every post. Really appreciate your insight and humor!

Today I’m 11 days post-op for my double jaw surgery with hip graft, called “Maxillary Lefort I w/ Iliac Crest Bone Graft and Mandibular procedures.” It said I paid for 3 surgical splints, but I only have 1 little removable retainer on the roof of my mouth to keep my arch from moving back in… now that I see that cost, I’m gonna have to see where the other 2 splints are, cuz they’re $1,500 a piece! 🙂 My diagnosis was “maxillary retrognathia with constriction and maxillary vertical deficiency with mandibular prognathism.”

Brief history: I’ll be 35 this Friday. In 7th grade, my folks were given the option of (now old school) jaw surgery where my jaw would be wired shut for weeks, or braces. This was to address my developing underbite, so they opted for the latter and 6 years of braces ensued.

Fast forward to the last few years: my last 4 dentists have all said: “You need braces again, followed by jaw surgery” to which I always replied, “Seriously?! I had braces for 6 years!”

I went to an orthodontist here in town, he confirmed what my dentists were saying, and said he could do 6 months max of braces in prep for surgery by Dr. Dale Bloomquist (https://dental.washington.edu/people/dale-s-bloomquist/), then maybe 2-3 months of braces after Dr. B’s done with me. Dr. B said my jaw did not develop in all 3 planes: down, forward and in archwidth, and the 6 years of braces “didn’t do me any favors.”

My malocclusion consisted primarily of open-bite and cross-bite since my maxilla was narrower than my mandible arch, and my rear molars were the only teeth touching, so they were ground down flat. If I didn’t do this, I would have continued bone loss, my bite contributed to significant gum recession, as well as root caries (decay near the base of the tooth more common in older folks), and eventually I would likely lose my teeth early.

Finally, my question: my teeth were brought down I believe 5mm, and my upper arch widened by 11mm. I have already asked my surgeon, and they insist I’m fine. But I have a small pinhole in the roof of my mouth that connects to my sinuses. Did you have any open connection between your mouth and nose after surgery? They do all of the cutting from above (which is creepy, yet awesome) so none of the cuts can be felt by the tongue. However, when I talked to his surgical assistant, since they widened my arch so much, it’s probably just a pinhole that will close. But I’m reading on the web, and of course I’m hearing good and bad things, as in I might need a graft to cover the hole.

Hi Joey, nice to meet you! It sounds like your path to correcting your bite is nothing short of a nightmare, but I assure you it’s a story I’ve heard dozens of times over the years. You’d be surprised at how many people have braces during their younger years only to find out they need to go through the entire process again before surgery. My orthodontist actually refused to put me in braces until I was in my early twenties for this exact reason. It really frustrated me at the time because I wanted to straighten my teeth in the name of confidence (and, at that age, likely vanity), but in hindsight, I’m really thankful they kept telling me “no.”

First, the splints. As Joe mentioned, surgeons are known to use multiple splints during the operation to provide structure to your mouth so your upper palette doesn’t cave in. I’m not sure if there’s any way to prove whether the surgeon did or did not actually use them. You may be able to find other Americans who have already dealt with the question of multiple splints by joining the chat group. Let me know if you want an invite and I’ll add you.

Second, the pinhole in the roof of your mouth. While I think bone will naturally grow to fill small gaps, it’s important to note that the hole in the roof of your mouth is not a natural gap because your surgeon expanded your palette. I had the same thing done and my surgeon filled the space in with cadaver bone. Since your palette was expanded so much, it was probably necessary to graft bone from your hip to ensure your body would not reject it. To answer your question, I was not aware of any holes in the roof of my mouth following surgery and do not experience anything of the sort today. It may be worth giving your body a month or so to see if the bone fills in. I would also recommend asking your surgeon to take a look at it at every follow-up appointment just to see if they notice any progress in that area.

I hope this helps a bit. Again, I do encourage you to join the chat group because you might find people who have been a similar situation there. Take care for now! 😊

Thanks Graham, I think I will join the chat. Not sure where that takes place. I think I’d have quite a few general questions here and there (like just now, I very very gently blew my right nostril, and hence got a bit of a nose bleed. Now that I think about it, my body might be trying to heel that hole in the roof of my mouth from above i.e. inside the nasal passage, which makes it feel like a booger I need to get out.)

I just sent you an invite to the chat. It will have instructions on how to join.

Also, not sure if your surgeon mentioned this, but do not blow your nose during the first month of recovery and then only blow it very gently and slowly during weeks 5 and 6. Blowing your nose can dislodge important blood clots that your body creates when trying to heal the surgical cuts in your mouth and nose and these can set you back in recovery. This may be why your nose stared bleeding this time.

It’s quite frustrating not being allowed to blow your nose because you will feel congested, but try your best to rely on rubbing something with menthol in it under your nose to clear your sinuses. 😊

Hello
I am one week post op I had double jaw surgery.. One side of my face was bigger than the other because my top and bottom jaw grew bigger from one side so I decided to get the surgery but I still feel like my face looks asymmetric I know it’s only been one week since surgery but I feel like the problem should have been fixed I’m wondering if it takes time or did my surgeon mess up? Hope I made sense thank you 😀

Annelise, it’s honestly very difficult to tell this early in your recovery due to extreme swelling. I found I wasn’t able to see the true shape of my face until around 2 months into recovery and friends told me I appeared slightly swollen until around 4 months had passed. As frustrating as this may sound, I encourage you to remain positive and give yourself a couple of months before passing too much judgement on your appearance. 😊

Hi , Annelise. sorry to interrupt.
I have the same problem as well! 🙁
My right side is bigger than my left side which caused severe crossbite. I am getting my surgery in 2.5 weeks. My doctor said it cannot be fixed 100% but will be better than before. I hope you recover well .

Hi Graham,
I had double jaw surgery to correct a gummy smile and lower jaw protrusion. I am almost 12 weeks post op. However, I haven’t been able to speak clearly ever since the surgery. Like I can’t pronounce my T’s, D’s and R’s correctly anymore. Also I am still unable to eat anything crunchy like chips or Oreos as it hurts my teeth. Is this normal?

Sanjana, I think you should be able to speak clearly at this point in your recovery. Usually swelling gets in the way of clear speech, but much of that should be gone by now. Another factor is your brain learning the new shape of your mouth. As long as your jaws are aligned properly (which they should be, since you had this surgery), you should have the capability to speak clearly, but it might take some interim training to achieve that. You might want to see a speech therapist to see if they can recommend any exercises to clear up your speech.

As for being unable to eat hard foods, it’s possible your jaws just need another month of strengthening to be able to handle this. I recall being able to eat anything I wanted at some point after 4 months of recovery, so I don’t think you have anything to worry about in that regard just yet. Hope this helps! 😊

Hello everyone I’m 5 1/2 months post op and I still can only open about 2 1/2 fingers width… More like 2 lol is that normal? Does anyone know what else to do… I told my surgeon but he didn’t seem concern… I do my jaw excersie but still no luck on opening wider… Any help from anyone 😔

Rachel, you should certainly be able to open your mouth wider than 2.5 finger widths by this point. I think that kind of restriction means the muscles in your jaw need to be stretched. Apologies if you’ve heard all this before.

Which types of exercises are you doing? I recommend whistling several times throughout the day (this breaks up scar tissue), chewing gum all day long (constant movement in your jaw should stretch out your muscles), and singing on a daily basis. 🎵

Also, do you feel any pain when you try to open your mouth wider? If there is pain, you might want to get an x-ray to confirm the screws and bone are okay. If you have no pain, then it’s likely just a game a exercise and patience.

Thank Graham! I’m doing the thumb and index finger to open the jaws! I do chew gum but not every day because I still bite me self 😏 I emailed my surgeon and he wants to see me to evaluate my opening and possibly refer me to physical therapy 😞 I do a lot of talking at work but I guess it didn’t work … My mouth stills very tight so I hope I don’t stay like that 😢 thank you for your response 😉

It sounds like you are taking action to solve the problem, so that’s encouraging to hear. 😊 I honestly don’t think this is something to fret about too much because those muscles should eventually stretch out. Perhaps they are just being stubborn at the moment! 😄

I had my double jaw surgery three years ago and had the same issues. My problem was that my discs in my joints became displaced (either before or after surgery) and would not go back in. The reason for not being able to open my mouth more than about a thumb width was that my previously damaged discs from having TMJ problems since I was 12, were balled up, flipped backwards, and my discs were not between my bones at all…therefore the discs were blocking my mouth from opening. I would VERY MUCH recommend that you see your surgeon and request a TMJ MRI or at least an answer. My surgeon is excellent. But…I did suffer severe complications since I had TMJ issues prior to surgery. I am one of less than 1% of people who have this surgery whose bones remodeled in the joints after surgery. I’ve since had 6 additional surgeries (2 major, 4 less major). I’m now back in braces to have my lower jaw redone as my bite has severely relapsed and is worse than I started with. Did you have TMJ issues before your surgery? Are you having pain? I don’t mean to scare you…I just don’t want anyone else to go through what I’ve been going through and think your doctor should look into it a bit more! Thinking positive thoughts for you! I hope you are pleased with your results of your surgery. Other than my issues, I have seen benefits from the surgery and hope after my lower jaw is redone, all of the benefits will be back! Good luck!

I had my original double jaw surgery August 2013. After that my joints started acting up so I had bilateral arthrocentesis (needles placed into joints and flushed, joints are also manipulated to break up scar tissue). This didn’t work, my discs were still displaced so they did another arthrocentesis on one side only. This lasted 12 hours. So, in July 2015, I had bilateral fat graft surgery. They removed the badly damaged discs and put fat from hip up there to replace the discs. I started feeling slightly better and went to PT. In one PT session, the fat graft was pushed out and damaged. My open bite started returning and my pain was so high. My surgeon tried one more arthrocentesis in November 2015 which lasted less than 48 hrs. In January 2016, my y surgeon redid the fat graft on that side. However my bite never closed…I only touched on the back molar…4-5 mm open bite which was worse than what I started with. So, on Monday (2 days ago) , I had my lower jaw surgery redone). The surgery was successful and my teeth now touch and I’m slowly recovering. So 2 (double first time, lower jaw this time) surgerie to fix my jaw structure, 4 arthrocentesis on my joints, bilateral TMJ surgery, single TMJ surgery…all in 34 months. I’d rather not say my surgeon’s name..sorry!

Is your surgeon in NY? The same surgeon did all of the surgeries? All that stuff sounds horrible!! I had some TMJ issues ever since I had all 4 impacted wisdom teeth extracted when I was about 16. Im not exactly sure what the cause was but after the extractions my jaw was swollen closed and off to the side for over a week. I wasn’t able to move my jaw at all for a week and after that it has never been the same. It clicks on occasion, it sometimes feels like it is about to slip out of place when I yawn, and my jaw gets really tired when I chew. I read somewhere that TMJ is sometimes caused by oral surgeons leaving in the appliance that keeps the mouth open during surgery for too long . Its either that or my joints were damaged when my jaw swelled up and was dislocated. As the swelling subsided I could actually feel my jaw joints going back into position and it wasn’t until then that I was able to open and close my teeth little by little. I can’t even imagine what the swelling from double jaw surgery would do. If I had no control over my jaw after wisdom teeth extractions wouldn’t the same or worse happen to me after double jaw surgery?
What will be the outcome of your jaw joints now? If they removed your jaw joints what’s keeping your jaw in place? They are now creating printable bone implants using 3D printers and a substance that while not exactly bone, it does allow your bone to fuse with and grow blood vessels into it just as if it were your own bone. I wonder if this could be used to replace your damaged discs?

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